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ICD-10 Guide
ICD-10 CodesS01.551

S01.551

Billable

Open bite of lip

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 S01.551 is a billable code used to indicate a diagnosis of open bite of lip.

Key Diagnostic Point:

An open bite of the lip refers to a laceration or injury characterized by a break in the skin and mucosa of the lip, often resulting from trauma. This type of injury can occur due to various mechanisms, including accidental bites, falls, or blunt force trauma. Clinically, an open bite may present with bleeding, swelling, and pain, and can be associated with other injuries to the oral cavity or facial structures. The management of an open lip bite typically involves cleaning the wound, controlling bleeding, and assessing for deeper tissue involvement. In some cases, suturing may be necessary to promote healing and minimize scarring. Complications can include infection, scarring, and functional impairment of lip movement. Accurate diagnosis and coding are essential for appropriate treatment and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in injury severity and treatment requirements
  • Potential for associated injuries in the oral cavity
  • Need for precise documentation of the mechanism of injury
  • Differentiation from other types of lip injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the extent of the injury
  • Misclassification of the injury type (open vs. closed)
  • Lack of follow-up documentation for complications

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation should include the mechanism of injury, initial assessment findings, and treatment provided.

Common Clinical Scenarios

Trauma cases involving falls, sports injuries, or assaults leading to lip injuries.

Billing Considerations

Ensure to document any associated injuries to the teeth or oral cavity.

Surgery

Documentation Requirements

Operative reports must detail the surgical procedure, including any suturing techniques used.

Common Clinical Scenarios

Surgical repair of extensive lip lacerations or reconstruction following trauma.

Billing Considerations

Document any pre-existing conditions that may affect healing or surgical outcomes.

Coding Guidelines

Inclusion Criteria

Use S01.551 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the nature and extent of the injury
  • Document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S01.551 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wounds of the face, ears, eyelids, nose, lips

Clinical Scenario

Used when suturing an open lip injury.

Documentation Requirements

Document the size of the wound and the technique used.

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of an open bite.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which improves the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of injuries, including open bites, which improves the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between an open bite and a closed bite of the lip?

An open bite involves a laceration or break in the skin and mucosa, while a closed bite does not penetrate the skin and is typically a bruise or contusion.